Twelve years ago, before Plan B was readily available without a prescription and before the RU-486 was legal in the U.S., Amalia Dominguez (pictured) wanted to have an abortion.

Amalia Dominguez was 18 and desperate and knew exactly what to ask for at the small, family-run pharmacy in the heart of Washington Heights, the thriving Dominican enclave in northern Manhattan. “I need to bring down my period,” she recalled saying in Spanish, using a euphemism that the pharmacist understood instantly.

So the pharmacist gave her a prescription for misoprostol, which at that time was solely used for ulcers and is now part of the one-two punch of most chemical abortions when used in concert with RU-486 (mifepristone).

Its use without a doctor's care to induce abortion is, to say the least, not recommended by the manufacturer.

A spokesman for Pfizer, which manufacturers Cytotec [misopristol], declined to comment beyond saying that the company does not support the off-label use of its products and noting that the label includes “F.D.A.’s strongest warning against use in women who are pregnant.”

That warning, in capital letters, also notes that the drug “can cause abortion.”

But it does not always do so, not least because notions of how best to use it vary from inserting several pills into the vagina to letting them dissolve under the tongue. The side effects can be serious, and include rupture of the uterus, severe bleeding and shock.

So why in the age of birth control, legal surgical abortion and legal chemical abortions do women still use this and other equally dangerous and ineffective methods to end pregnancy?

Researchers studying the phenomenon cite several factors that lead Dominican and other immigrant women to experiment with abortifacients: mistrust of the health-care system, fear of surgery, worry about deportation, concern about clinic protesters, cost and shame.

“It turns an abortion into a natural process and makes it look like a miscarriage,” said Dr. Mark Rosing, an obstetrician at St. Barnabas Hospital in the Bronx who led the 2000 study, which was published in the Journal of the American Medical Women’s Association. “For people who don’t have access to abortion for social reasons, financial reasons or immigration reasons, it doesn’t seem like this horrible thing.”

Lee and Buckley cite stories of women scared of their parents and friends finding out, scared of deportation, women who felt unwilling to demand the use of condoms in their relationships for fear of being labeled as promiscuous and who often used the euphemism of "bringing on their periods" to linguistically deny the reality of inducing an abortion.

But, as with other methods of inducing abortions, these women risk incomplete abortions, health problems and even death, just to avoid clinic protesters, gossip, religious shame and even the potential for deportation. Safe, legal and rare is great, but where is shame-free in that formulation?

For Privacy’s Sake, Taking Risks to End Pregnancy [New York Times]

"You just keep having children. This is how you keep a man," Sylvia, mother of twelve, told Maternowska. "If you don't give [children] to him, he doesn't give [money] to you.... And sometimes even if you do give, you lose anyhow. Life is hard." Women would do anything to keep a man. There was a brisk trade in sexy outfits and wild rumors circulated about love potions, some from voodoo healers, some home-made, including rice and beans cooked in water in which a woman had washed her underwear.

That's a passage about Haiti. Haiti, poorest country in the Western hemisphere…is there enough rice in Haiti to waste on a man who might leave? Or can a woman cook dirt cookies in her underwear water, too? Not uplifting questions, sure, but what exactly did the World Bank so fear from these people that they were willing to endorse the literal dragging of Indian women to sterilization clinics and worse, the measures that in China all too often resulted in forced third-trimester abortions?

Well, eugenicists feared the introduction of the Pill into the First World would cause "the swamping of the Nordic and Anglo-Saxon races by imbeciles, blacks, Asians, and eastern and southern Europeans," and technically, that happened. By the late sixties, books like the Population Bomb had softened that message, focusing on India where the (not improbable) prophesy was that "squalid, teeming slums and mass starvation" would beget "imminent political collapse." Ahhh, political collapse, our generation knows it well! But then what?

Particularly after the Communist takeover of China in 1949, Washington policymakers began to fear the rise of an increasingly resentful—and rapidly proliferating—global population of poor people who were easily susceptible to radical ideas and militaristic leaders. But in the end such people, if they threatened anyone, were mainly a danger to themselves.

As we know from the poor countries in which we've brought about political collapse lately!

Helen Epstein's whole review is worth reading — and the NYRB is worth subscribing to and makes a great gift for dads! — but here's a critical line. As anyone who has ever been in love knows, treating others humanely might come more naturally when you suspect they might have the capacity to hurt you.

The greatest threats to the global climate come from China and the West, where birthrates are extremely low. The future of the planet depends less on the number of babies born in Uganda than on the choices we in the West make, which, at the moment, are not good ones. As recently as 2004, a Japanese study found that when shopping for cars, Americans cared more about the size of the cup holder than fuel efficiency.[10] Our habits may be shifting, but ever so slowly.

The Strange History Of Birth Control? [New York Review Of Books]
Earlier: Is It About Time We Made A "Pregnancy Pact" Of Our Own? [Jezebel]

Related: New Limits To Growth Revive Malthusian Fears [WSJ]
RU-486: Brought To You By John D. Rockefeller [Some weird website I don't think is related to antiabortion zealots]

But enough of that; here we have a man, not a closeted gay Bible-thumping Evangelical career fearmonger but a middle-of-the-road retiree clearly realistic enough about the abortion debate not to let it steer his presidential vote away from a pro-choice candidate, exploiting the very weakest opportunity to pass an unconstitutional law because that's just how nuts people get over the abortion debate.

Anyway, I direct your attention to it not because I think it will pass, but because I truly wonder: why don't middle-of-the-road Catholics just go ahead and embrace the abortion pill already?

If you think abortion is wrong — not "murderous" enough to let it eclipse all other policies guiding your political decisions, perhaps, but not a good thing — shouldn't you look at RU-486, sort of like the Plan B "Morning After" pill, as a form of harm reduction? I know lots of Catholics (sigh) who privately do. It is generally only approved for the first seven weeks of pregnancy, before the whole "beating heart" thing, before the ultrasound looks like anything but a mess of cells, before the embryo even technically can claim the designation "fetus." But beyond that, pill abortions, performed at home without anesthesia, suck. They're personal. They hurt. Sometimes like hell. You bleed for a week, or longer. Look it up on the internet: women invariably describe them as "emotional." They are. If you're down for feeling a sense of loss about the whole thing, if you're at all reflective, if you — fuck, if you want to atone, you know, go ahead, it's your call — it's totally the way to go. And most importantly, once you've had one, you don't really want to do it again. (Not that you ever do, really.) I'm not saying anyone should feel this way about the choice to have an abortion. But a lot of us do. So why should we be treated like we're trying to score hallucinogens?

Missouri House Adds Abortion To Restrictive List [Kansas City Star]

Some of comments following the CBS News story about the situation in Sweden seem to imply this. Says one:

I don''t understand how pro choice people can say if the fetus isn't wanted by the mother she can terminate it and it is not murder. But if a pregnant woman who wants her baby is kicked in the stomach or some other act of violence ends the life of that unborn baby...then it can be considered a murder. Well it can''t be both ways. So the law says a woman (host of the parasite) gets to decide if her child is a parasite or a baby!!?? How sick this all is...

I find it interesting that he gets sentenced to 18 months in prison for trying to get rid of the fetus and she can legally get rid of the fetus by having an abortion.

Man Jailed For Abortion Pill-Laced Yogurt [CBS News]
Physical Abuse Linked To Premature Births [UPI]

Related: Murders Of Pregnant Women Rising [CBS News]
Murder Most Foul [Salon]
Murder: The Leading Cause Of Death For Pregnant Women [NOW]
CDC Explores Pregnancy-Homicide Link [WaPo]

Meanwhile, the vast preponderance of abortions are conducted in the first half of the first trimester of pregnancy, increasingly by women who forego any sort of anesthesia so as to carry about their abortions at home with the help of some pills. And, guess what, it hurts!

Soooo, recently I found myself researching the pain involved in pill abortions, namely because a friend of mine had told me that most purveyors of the pills don't prescribe the FDA-recommended regimen of 600 mgs of RU-486 followed by an optional few hundred mgs of something called misoprostol a few days later, because they had found a new regimen — of 200 mgs of RU-486 plus 600 mgs misoprostol all at once — that was "more effective." This friend had also found the new regimen to be really really painful. But when I started researching the differences between the two pharmaceutical cocktails, I found a lot of evidence that the new regimen was a lot cheaper, and numerous studies claiming it was just as effective, but nothing about the pain.

Jesus Shit! I thought. There are motherfucking studies about the responses of women on birth control to porn, there are studies on the impact of videogames on navigational skills, there are probably studies on the prenatal effects of playing video games during the third trimester, and there are no studies about abortion and pain? Is it too late to sign up for that whole "woman president" thing?

The First Ache [NY Times]
Little Children [NY Times]

Although a FDA spokesman said "[We are] not aware of any evidence to suggest the issue that occurred at the leukemia drug facility is linked in any way with the facility that manufactures the mifepristone", Shanghai Hualian doesn't exactly have the greatest recrod: In 2002, shipments from the company were stopped at the U.S. border because they were unapproved or mislabeled, and pharmaceutical behemoth Pfizer won't import from Hualian at all because of its concerns with quality issues.

What is currently unclear and mildly troubling is why all the mifepristone in the United States is manufactured by a single company at a single factory in a country with a checkered history of drug regulation. Instances of bribery in the Chinese drug industry are so extreme that the top drug safety official was executed last year because he had accepted money to approve drugs. In addition, the same inspector responsible for the factory producing the tainted cancer drug, Gu Yaoming, met with F.D.A. brass in conjunction with the RU-486 factory inspection, all of which makes Tuesday's news that the FDA is the equivalent of 13 years behind in inspecting foreign drug manufacturers all the more inspiring!

Finally we have to wonder whether this news will affect the number of non-surgical abortions in the United States. Since RU-486 was introduced in 2000, the percentage of abortions performed through the pill has risen steadily, and at this point 14% of all abortions are "miffy" induced. Does this new information make you wary of taking RU?

Tainted Drugs Linked to Maker of Abortion Pill [New York Times]
Related: For F.D.A., A Major Backlog Overseas [NY Times]

Earlier: Experts Don't Understand Why Fewer American Women Are Getting Abortions

Uh, right. The harsh reality, however, is that if access to abortion is further imperiled, the women who will truly suffer are the poor, not teens from Philadelphia suburbs with median incomes of $90,000. And although this is not a new revelation, several women have published specific anecdotes underscoring that point. Activist and Radcliffe fellow Kissling also writing in Salon, tells the story of Rosie Jimenez, a woman who died from a back-alley abortion in 1978 because Medicaid funds for abortions had been cut off. The botched abortion had caused an "infection that had turned her skin a dark greenish brown and caused blood to seep from her eyes." Rural women are affected deeply, too. Erica Sackin relates a story about a friend who " had to drive 15 hours and two states out of small-town Texas to an abortion clinic — a clinic that has since closed." Here at Jezebel we shared own stories of abortion, and asked you to share your own, in the hopes of lessening the stigma attached.

The message to be gleaned from today's anniversary is that the fight for our reproductive rights is not something that languishes in the distant past. It's a battle being waged every day by embattled abortion providers in Albuquerque who will only speak anonymously to the Washington Post about "Miffy" or mifepristone, the abortion pill, for fear of local retribution. An abortion ban is such a feasible reality that the NARAL pro-choice organization has developed a map showing which states are likely to outlaw abortion if given a chance to. (What would happen in your state?) On the anniversary of Roe v. Wade and, in an election year with several geriatric Supreme Court judges on the verge of retirement, the least we can do today is remember that our reproductive rights aren't something to be taken for granted.

Abortion's Battle Of Messages [Los Angeles Times]
Anti-abortion Cause Stirs New Generation [Los Angeles Times]
Voices: A Real Anniversary Present [Metro]
Roe, 35 Years Later [Salon]
As Abortion Rates Drop, Use of RU-486 Is On Rise [Washington Post]
Map [NARAL]

Earlier: Unlike Alveda King, I Am Neither "Reformed" Nor A Murderer
Experts Don't Understand Why Fewer American Women Are Getting Abortions